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HSA Application
 


To apply for a Health Savings Account:


To return a completed application by mail, send to:

Union Bank & Trust
Attn: HSA Coordinator
PO Box 82535
Lincoln, NE 68501-2535
 
   
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Important Information About Procedures For Opening A New Account—
To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you; we may also ask to see your driver’s license or other identifying documents.

FDIC Insurance:
For general information on FDIC Insurance, click here. For an important disclosure regarding deposit insurance on noninterest-bearing transaction accounts, click here.

**Insurance policies are obligations of the issuing insurance company, and are not obligations or deposits of, or guaranteed by any bank and are not FDIC insured. Annuities subject to investment risks, including possible loss of the principal amount invested. Union Bank makes insurance available through its affiliated company Union Agency Inc.
©2011 Union Bank & Trust Company. All Rights Reserved. MEMBER FDIC.